The largest of the ductless glands, the spleen is situated in the upper left-hand comer of the abdomen, towards the back and just below the diaphragm. It lies in front of the ninth to the eleventh ribs. Its shape somewhat resembles that of a segment of an orange, and in an adult it weighs rather less than half a pound. It is dark red in color. Its front edge is usually notched, and when enlarged and the edge comes below the margin of the ribs, the notches can be felt.
The spleen is surrounded by a fibrous capsule from which processes, or trabeculae, pass into the interior of the organ, dividing it up into numerous spaces, which are filled with a soft material – the spleen pulp. In this are to be seen numerous small round bodies, the Malpighian corpuscles, which are agglomerations of lymphoid tissue. The blood vessels of the spleen are large. The capillaries into which the artery breaks up open into blood spaces from which other capillaries take their origin and conduct the blood to the splenic vein, which is a tributary of the portal vein.
The spleen contributes new corpuscles, both white and red, to the blood, and in the spleen there is partial destruction of the effete red corpuscles. It also aids in the fight against infection, and probably has other functions. It is not essential to life, however, as there is no interference with health when the organ is removed inconsequence of an injury.
The spleen may be ruptured by a crush or a blow, and more readily if it is enlarged, when, in fact, it may even rupture spontaneously. Like other abdominal organs, the spleen may sag downwards, and it has occasionally happened that the displaced organ has been twisted sufficiently to occlude its blood vessels and cause gangrene of the spleen.
Enlargement of the spleen, or splenomegaly, may occur from a large number of causes. When acute, it may be associated with considerable pain and tenderness beneath the ribs on the left side, and also in the back, but when chronic the only complaint may be that of fullness or weight on the left side of the abdomen.
In the tropics an acute enlargement of the spleen is most often due to malaria, but kala-azar and other tropical diseases are other possible causes. Enteric fever, streptococcal septicemia, pyemia, anthrax and other infections which occur anywhere, are also causes of acute enlargement. Sometimes an abscess occurs on the organ, and this causes acute pain as a rule.
Chronic enlargement may be due to malaria, leukemia, splenic anemia, pernicious anemia, Hodgkin’s disease, amyloid disease, hydatid disease, and other disorders, and in some of these the organ may fill the whole of the left side of the abdomen and weigh many pounds. Cancer and other tumors may occur, but only rarely.
Treatment depends on the cause, and, except in splenic anemia, in which removal of the spleen may cure the disease, is more concerned with other conditions than with the spleen itself.
A disease for which changes in the spleen appear to be primarily responsible is described as splenic anemia. Males are frequently attacked, and usually at or before middle age.
Commonly the first indication of the malady that is noticed by the patient is fullness and a sense of weight in the abdomen. There is an increasing pallor and shortness of breath on exertion, and in the course of time the legs show signs of dropsy when the patient has been up and about. There may also be bleeding from mucous membranes, so that blood may be passed in the stools or urine, or be vomited.
Later there is cirrhosis of the liver with jaundice and the accumulation of dropsical fluid in the belly, or ascites. This stage is often referred to as Band’s disease (after the Italian pathologist, Guido Banti, 1852, 1925, of Montebicchiere).
The infantile affection, anemia infantum pseudo-leukaemica, known as von Jaksch’s disease (after Rudolf von Jaksch of Prague), possibly of the nature of splenic anemia. The treatment at the beginning is usually that of anemia (q.v.) simply, but removal of the spleen is necessary to radical cure. See: Anemia..
Application and treatment:
Apply negative polarity on left side of spleen and positive polarity on right side to relieve pain: 5 to 30 minutes.
Treat other symptoms as listed, but accompany these measures with standard treatments via water pans.